An intubation is a medical act that should be done by one person under emergency conditions without neither special heavy equipment nor special room. A tube is inserted into a patient's trachea in order to ensure that the airway is not closed and that air is able to reach the lungs. Although endotracheal intubation is regarded as the most reliable available method for protecting a patient's airway, many so called difficult intubations happen leading sometimes to extremely severe consequences including neurological disorders due to hypoxia and to patient's death. The majority of difficult intubations will be predicted by clinical assessment and have been classified into four grades proposed by Dr Cormack, according to the view from the throat. The more the airway appears to be hindered, the highest is the grade and thus the predictable difficulty to intubate. A grade I intubation will proceed straightforward as the trachea is well open and relatively straight whereas a curved or hindered trachea shape present in a grade III or IV intubation (a difficult intubation) will imply repeated attempts at intubation and difficulties or impossibility to introduce the endotracheal tube. These difficulties are due to the low visibility of the airway and are due to the shape the intubation device must adopt.
Many solutions were explored and implemented. An intubation stylet to be inserted into an endotracheal tube is known from EP 1 177 809. Such a stylet is provided with fiber optics and with manipulation means cooperating with a spring which helps bend the tube to a desired form. This kind of stylet can theoretically be used with any kind of endotracheal tube but is costly and non disposable, and multiuse. It therefore does not meet decontamination requirements.
The patent document WO 02/056951 describes a tracheal tube comprising a light guide and an aspiration trocar allowing visualization of the airway of the patient during intubation and suctioning the debris. The patent document U.S. 5,285,778 describes an endotracheal tube comprising a pair of optical fibers to enlighten and to visualize the area around the distal end of the endotracheal tube during the intubation. None of the existing solutions permit to solve in a satisfying manner the problems encountered during difficult intubations. In particular a stylet as described in EP 1 177 809 is required, which represent a source of possible contamination.
Any intubation procedure implies that the cuff of the endotracheal intubation device must be carefully controlled prior to intubation in order to ensure the patient's throat will be hermetically closed to potential gastric reflux. Moreover the sterility of the device prior to and all through the intubation must be preserved which complicate significantly the control procedure.
Prior to a surgery an endotracheal intubation device must be controlled and prepared to counter possible complications. Opening of the sterile packaging is generally required to control the cuff and the endotracheal intubation device must be thus disposed of, no matter the endotracheal intubation device has been used during the surgery.
In emergency case, controlling the cuff means a loss of time that should be reduced.
There is a need for an endotracheal intubation device that allows simplified procedures and that avoids all the above mentioned issues. There is still a need also of an endotracheal intubation device facilitating so called difficult intubation without any help of an external device like a stylet. The present invention is designed to overcome at least part of the aforementioned difficulties or drawbacks and to help conduct the intubation into the trachea without any external device.